ABSTRACT
In menarchal or pubertal girls, a variety of gynaecological problems may cause abdominal symptoms, including the exaggerated intraperitoneal bleeding of ovulation, rupture of a small luteal cyst, tubal menstruation, torsion of the ovary, acute salpingitis and primary peritonitis. Developmental abnormalities are rare in girls. Imperforate hymen presents either at birth, when mucus secreted by the vagina accumulates beneath a bulging imperforate hymen to form a mucocolpos, or at puberty, with amenorrhoea and haematocolpos or haematometrocolpos, with or without cyclical attacks of abdominal pain. A number of masses may appear in the perineum, particularly in girls. They may appear from the urethra or the vaginal opening, and the external appearance may give little clue to the diagnosis. For example, a rhabdomyosarcoma protruding through the urethra may have a similar appearance to that of a urethral polyp, prolapse of the urethral mucosa or a prolapsing ureterocele.
